Up to Sixty Percent of Surveyed U.S. Managed Care Organization Directors Expect to Cover Key Emerging Therapies for Parkinson's Disease on Their Largest Commercial Plan Neurologists Surveyed Estimate at Least One-Quarter of Their Diagnosed Patients Would Be Eligible for Emerging Products Queried, According to a New Report from Decision Resources
BURLINGTON, Mass., Aug. 19, 2013 /PRNewswire/ -- Decision Resources, one of the world's leading research and advisory firms for pharmaceutical and healthcare issues, finds that up to 60 percent of surveyed U.S. managed care organization (MCO) pharmacy and medical directors expect to reimburse several late-stage emerging Parkinson's disease (PD) therapies on their largest risk-based commercial plan. Profiled in the report are four emerging agents that target primarily underserved populations, including IPX-066 (Impax Laboratories' Rytary), an extended-release reformulation of levodopa (multiple brands, generics), the mainstay of PD treatment, Acadia Pharmaceuticals' pimavanserin for PD-related psychotic symptoms, Novartis's mavoglurant (AFQ-056) for dyskinesias and Newron Pharmaceuticals/Zambon Pharma/Meiji Seika Pharma's MAO-B inhibitor safinamide.
The U.S. Physician and Payer Forum report entitled The Complex Parkinson's Disease Treatment Algorithm: U.S. Physician and Payer Perspectives on the Current and Future Landscape finds that formulary exclusion can be common for current PD brands, with at least one-third of MCO respondents indicating that their largest commercial plans and Medicare prescription drug plans exclude or block key brands from coverage. The most recent market entrant, UCB's dopamine agonist Neupro (rotigotine), is similarly covered, despite offering once-daily dosing and unique transdermal delivery. Nevertheless, when reimbursing key current brands, surveyed payers largely include such agents on tiers 2 and 3 (i.e. commonly preferred and non-preferred brands, respectively), and generally expect similar tier placement for the emerging agents profiled if priced at approximately $10 per day or higher.
The report also finds that surveyed neurologists estimate the eligible patient pool for emerging products queried to be no less than one quarter of their diagnosed PD patients, on average. Moreover, they anticipate that up to two-thirds of eligible patients would be treated with each product within one year of launch, with IPX-066 projected to capture the greatest patient share at approximately 25 percent of diagnosed PD patients if reimbursed on a preferred tier.
"Cost and reimbursement factors have a prominent role in determining the uptake of a PD therapy, but clinical considerations most influence prescribing decisions," said Decision Resources Senior Business Insights Analyst Nadja Rozovsky, Ph.D. "Despite the potential for certain constraints on reimbursement and finite patient eligibility, commercial opportunity remains for key late-stage investigational products in light of lingering unmet need."
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